Gastroparesis - Knowledge

804:, and pressure. Once ingested, the WMC continuously records measurements of the three variables as it moves through the gastrointestinal tract, and the information is wirelessly and in real-time transmitted to a receiver that the patient wears on their waist for the duration of the study. Gastric emptying time is regarded as delayed if it is 5 hours or longer and is defined as the time required for the capsule to reach the duodenum, as determined by a pH increase of more than 3 units. Small bowel transit time is normally 2.5–6 hours and is calculated from the time the pH increases by more than three units to the time it drops by more than one unit and is sustained for at least 30 minutes. This drop denotes the capsule's passage to the 808:. The colon transit period (normal is 59 hours or less) is calculated from the time the WMC enters the cecum till it is expelled from the body, as indicated by a sudden drop in temperature or signal loss. Patients consume a standardized meal that includes a nutrient bar accompanied by 50 cc of water on the day of testing. Patients must fast for 6 hours following consuming a meal. For the duration of the study, they are asked to press the EVENT button, record specific events in a diary, and then the receiver is gathered and the data is downloaded for analysis. 862:(diabetes mellitus) causes of impaired motility. The test shows a decreased frequency and amplitude of migrating motor complexes in patients with a myopathic condition. The migrating motor complexes in patients whose disease has a neuropathic etiology have a normal amplitude, but they are ill-coordinated and cannot propagate. This test is not widely available, and more validation research is required. It is an invasive test that necessitates expertise to perform and comprehend the results. Furthermore, it is technically challenging, and the 812:

another advantage of using WMC in the diagnosis of gastroparesis. This is useful because extragastric impaired motility occurs in more than 40% of those with suspected gastroparesis and gastrointestinal symptoms do not correlate well with the gastrointestinal segment affected. Assessing the rest of the gastrointestinal tract in addition to gastric emptying provides information about motility in various segments of the gut, which can change management and improve symptoms.

723:-labeled egg sandwiches or Egg Beaters egg whites with 1–2 slices of bread, strawberry jam, and water. Previously, studies labeled both the solid and liquid phases of a meal; however, present standard tests just label the solid phase of a meal, since liquid emptying only becomes delayed in the most advanced stages of gastroparesis. However, when assessing for postsurgical anatomic issues or ruling out 31: 889:, which uses transaxial abdominal images to gauge gastric accommodation and emptying every 15 minutes. It can also distinguish between gastric meal and air and thus provide data on gastric emptying and secretions. It is, however, costly and necessitates specialized equipment; with the exception of research, it is not standardized across centers, limiting its use to research only. 642:

maximum nutrient absorption. The controlled rate of chyme released is regulated by feedback mechanisms from the stomach and small intestines, which activate the vagus nerve and other hormones. The delay of any of the factors in gastric emptying causes disorganization or reduced frequency of antral contractions and thus delayed GE.

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substantial nutritional deficiencies. Furthermore, 64% of gastroparesis patients consumed a calorie-deficient diet. Additionally, higher symptom scores were inversely proportional to caloric intake. Another study found that the severity of nutritional deficiencies was proportional to the duration of gastric emptying. Minerals like

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There has only been one true epidemiological study of idiopathic gastroparesis which was completed by the Rochester Epidemiology Project. They looked at patients from 1996 to 2006 who were seeking medical attention instead of a random population sample and found that the prevalence of delayed gastric

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People with gastroparesis are disproportionately female. One possible explanation for this finding is that women have an inherently slower stomach emptying time than men. A hormonal link has been suggested, as gastroparesis symptoms tend to worsen the week before menstruation when progesterone levels

980:, a procedure in which a part or all of the affected portion of the stomach is removed, has been shown to have some success in the treatment of gastroparesis in obese patients, even curing it in some instances. Further studies have been recommended due to the limited sample size of previous studies. 975:

to the muscles of the lower stomach to reduce the symptoms. This is only done in refractory cases that have failed all medical management (usually at least two years of treatment). Medically refractory gastroparesis may also be treated with a pyloromyotomy, which widens the gastric outlet by cutting

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in postsurgical patients, testing liquid emptying is valuable. Following ingestion, the patient undergoes standard imaging of the gastric area while standing, and the percentage of radioactivity left in the stomach is recorded using computerized software and normalized to the baseline value at 1, 2,

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smoking is also a plausible cause since smoking causes damage to the stomach lining. Idiopathic gastroparesis (gastroparesis with no known cause) accounts for a third of all chronic cases; it is thought that many of these cases are due to an autoimmune response triggered by an acute viral infection.

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via the portal circulation and metabolized to 13-carbon dioxide (13CO2) before being exhaled during expiration. Because stomach emptying is the testing process's rate-limiting step, the amount of 13CO2 present in an exhaled breath test represents gastric emptying. Every 30 minutes, post-meal breath

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is the most common symptom of gastroparesis. Abdominal pain has a wide range of symptoms. Around 40% of patients have localized epigastric pain, but it can be diffuse in some cases. Pain is usually classified as postprandial, but it can also occur at night and interfere with sleep. The severity of

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Gastroparesis present similar symptoms to slow gastric emptying caused by certain opioid medications, antidepressants, and allergy medications, along with high blood pressure. For patients already with gastroparesis, these can make the condition worse. More than 50% of all gastroparesis cases are

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residents who had definite gastroparesis symptoms, as well as diagnostic testing for gastroparesis, had a 5-year estimated survival rate of 67%, which was significantly lower than the population average. Old age at the time of diagnosis has been linked to a lower chance of survival. Nondiabetic

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Recent studies have also shown that pressure measurements can be used to differentiate diabetic gastroparesis, which is characterized by a reduced amount of contractions and motility indices when compared to healthy individuals. The ability to examine extragastric motility with a single test is

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Post-infectious gastroparesis, which constitutes the majority of idiopathic gastroparesis cases, affects up to 4% of the American population. Women in their 20s and 30s seem to be susceptible. One study of 146 American gastroparesis patients found the mean age of patients was 34 years with 82%

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The symptoms of gastroparesis are best understood in the context of the physiology of gastric emptying (GE). The stomach functions as a reservoir for food and nutritional content, which are broken down to produce chyme. Chyme is then released into the duodenum at a controlled rate to allow for

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Because of the debilitating symptoms, patients with gastroparesis are at risk of significant nutritional abnormalities. In one study, 305 patients with gastroparesis had their dietary intake and nutritional status evaluated, and the average caloric intake was 1168 kcal/day, which resulted in

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can provide information about gastric emptying, and complete gastric emptying is determined when the antral area goes back to its preprandial baseline. Three-dimensional ultrasound can provide information on meal distribution and stomach volume. It has also been proposed to use duplex

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gastroparesis. Cases of post-infectious gastroparesis are self-limiting, with recovery within 12 months of initial symptoms, although some cases last well over 2 years. In children, the duration tends to be shorter and the disease course milder than in adolescents and adults.

843:, pyloric, and duodenal contraction waves. The test can be performed in a stationary setting for 5–8 hours or in an ambulatory setting for 24 hours to evaluate duodenal motor function. Antroduodenal manometry reveals a decreased antral motility index in gastroparesis. 662:

to produce an electrical rhythm in the smooth muscle cells. Lower nitric oxide levels also correlate with loss of ICC cells, which can ultimately lead to the loss of function in the smooth muscle in the stomach, as well as in other areas of the gastrointestinal tract.

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and, in some cases, restrictions on fat or solids. Eating smaller meals, spaced two to three hours apart has proved helpful. Avoiding foods like rice or beef that cause the individual problems such as pain in the abdomen or constipation will help avoid symptoms.

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is the most commonly reported symptom, affecting up to 96% of gastroparesis patients. However, depending on the etiology, the predominant symptom reported can differ. The severity of gastric emptying dysfunction does not correspond to the severity of symptoms.

460:(SIBO). One study examined 50 gastroparesis patients using a glucose breath test and discovered that SIBO was present in 60% of their cohort. Furthermore, longer episodes of gastroparesis symptoms increase the risk of SIBO. Poor gastrointestinal motility and 919:

antagonist, increases contractility and resting tone within the GI tract to improve gastric emptying. In addition, dopamine antagonist action in the central nervous system prevents nausea and vomiting. Similarly, the dopamine receptor antagonist

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to examine transpyloric flow as well as liquid contents. While ultrasound appears to be an appealing safe technique, its use in the clinical setting is limited due to the significant expertise required and inadequate outcomes in obese patients.

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Postprandial fullness is an unpleasant feeling of stomach fullness that occurs after eating. Patients might characterize postprandial fullness as a feeling of food remaining in the stomach for an extended period of time. Satiation is a lack of

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may effect chemical changes in the nerves. The vagus nerve becomes damaged by years of high blood glucose or insufficient transport of glucose into cells resulting in gastroparesis. Adrenal and thyroid gland problems could also be a cause.

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due to unpredictable digestion times due to changes in rate and amount of food passing into the small bowel, a decrease in quality of life, since it can make keeping up with work and other responsibilities more difficult, and severe

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emptying was fourfold higher in women. It is difficult for medical professionals and researchers to collect enough data and provide accurate numbers since studying gastroparesis requires specialized laboratories and equipment.

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Rouphael C, Arora Z, Thota PN, Lopez R, Santisi J, Funk C, et al. (April 26, 2017). "Role of wireless motility capsule in the assessment and management of gastrointestinal dysmotility in patients with diabetes mellitus".

304:(GES; approved on a humanitarian device exemption) can be used as treatment. Overall survival in gastroparesis patients is significantly lower than survival in the general population. It is associated with poor outcomes. 649:

expression since the cells in the GI tract secrete nitric oxide. This important signaling molecule has various responsibilities in the GI tract and in muscles throughout the body. When nitric oxide levels are low, the

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Bloating is a highly subjective feeling of increased abdominal pressure. Bloating without eating should be distinguished from postprandial fullness. It is sometimes, but not always, associated with food consumption.

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illness of any kind, as a consequence of certain cancer treatments or other drugs which affect digestive action, or due to abnormal eating patterns. Patients with cancer may develop gastroparesis because of

749:, a blue-green algae that is 50–60% protein, 30% starch, and 10% lipids. Following an overnight fast, pre-meal breath samples are taken, and then meals are consumed. 13C-octanoate is absorbed in the 5098: 869:

Although transabdominal ultrasonography and magnetic resonance imaging (MRI) have been proposed as noninvasive diagnostic tools for gastroparesis, their use is currently restricted to research.

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Hyett B, Martinez FJ, Gill BM, Mehra S, Lembo A, Kelly CP, et al. (2009). "Delayed Radionucleotide Gastric Emptying Studies Predict Morbidity in Diabetics With Symptoms of Gastroparesis".

231:. This can result in irregular absorption of nutrients, inadequate nutrition, and poor glycemic control. The opposite of this, where stomach contents exit quickly into the duodenum, is called 476:, which significantly impair the GI tract's innate bactericidal activity. SIBO causes small bowel inflammation, impairing absorption and worsening nutritional deficiencies in gastroparesis. 983:

In cases of postinfectious gastroparesis, patients have symptoms and go undiagnosed for an average of 3 weeks to 6 months before their illness is identified correctly and treatment begins.

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has proven effective in the treatment of gastroparesis unresponsive to conventional treatment. This is due to its antiemetic and appetite stimulant properties. Mirtazapine acts on the same

936:, which increases blood flow to the genital area in men, is being used by some practitioners to stimulate the gastrointestinal tract in cases of diabetic gastroparesis. The antidepressant 1003:

gastroparesis who are more likely to develop complications. For example, one study discovered that over a 6-year period, 7% of those with gastroparesis died, with 22% requiring long-term

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Kloetzer L, Chey WD, McCallum RW, Koch KL, Wo JM, Sitrin M, et al. (2010). "Motility of the antroduodenum in healthy and gastroparetics characterized by wireless motility capsule".

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Van de Casteele M, Luypaerts A, Geypens B, Fevery J, Ghoos Y, Nevens F (2003). "Oxidative breakdown of octanoic acid is maintained in patients with cirrhosis despite advanced disease".

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Tougas G, Eaker EY, Abell TL, Abrahamsson H, Boivin M, Chen J, et al. (2000). "Assessment of gastric emptying using a low fat meal: establishment of international control values".

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Griffith et al. first described GES in 1966, and it has since become the gold standard for diagnosing gastroparesis. Following an overnight fast, the patient consumes a standardized,

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or disappearance of appetite while eating. Early satiety is the sensation of stomach fullness that occurs shortly after beginning to eat and is out of proportion to the meal.

4276: 328:. Symptoms of delayed gastric emptying tend to be exacerbated by eating, particularly after fatty foods and indigestible solids like salads and leafy vegetables. In general, 5564: 3281:

Kim DY, Myung SJ, Camilleri M (2000). "Novel Testing of Human Gastric Motor and Sensory Functions: Rationale, Methods, and Potential Applications in Clinical Practice".

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Individuals with gastroparesis are also more likely to develop gastric bezoars. Bezoars are large masses of foreign substances and food that have become trapped in the

380:. Early satiety is the disappearance of appetite before nutrient absorption during food ingestion. Early satiation may be described by patients with gastroparesis as a 4780: 453:, especially in the stomach. The incidence of bezoar formation in gastroparesis patients has been estimated to be approximately six percent based on a barium study. 796:

has approved the wireless motility capsule (WMC) for the evaluation of gastric emptying as well as colonic transit time for individuals with suspected slow transit

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Gastrostars - Patients organization for everyone with a stomach paralysis and other additional physical conditions such as a paralyzed or slow working intestines.

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Soykan I (1998). "Demography, Clinical Characteristics, Psychological and Abuse Profiles, Treatment, and Long-Term Follow-up of Patients with Gastroparesis".

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and 4 hours postprandially. Gastric emptying is considered delayed if there is more than 60% retention at 2 hours and/or more than 10% retention at 4 hours.

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Treatment includes dietary modifications, medications to stimulate gastric emptying, medications to reduce vomiting, and surgical approaches. Additionally,

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Clegg ME, Shafat A (May 6, 2010). "Procedures in theC octanoic acid breath test for measurement of gastric emptying: analysis using Bland–Altman methods".

4414: 530: 2800:"Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies" 4206: 3592:

Samuel B, Atiemo K, Cohen P, Czerniach D, Kelly J, Perugini R (2016). "The Effect of Sleeve Gastrectomy on Gastroparesis: A Short Clinical Review".

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as the root of their symptoms, those patients should be tested for gastroparesis. There are several tests available to diagnose gastroparesis, with

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absorption, 13C metabolism in the liver, and pulmonary exhalation of 13CO2. Physical activity is another factor that can influence CO2 excretion.

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Gastroparesis is suspected in patients who have abdominal pain, nausea, vomiting, or bloating, or when these symptoms occur after eating. Once an

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medications can cause medication-induced gastroparesis. Chronic gastroparesis can be caused by other types of damage to the vagus nerve, such as

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Treatment includes dietary modifications, medications to stimulate gastric emptying, medications to reduce vomiting, and surgical approaches.

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was 250% greater (.1% of the patients) than the number of patients diagnosed with gastroparesis who did not take a GLP-1 medication (.04%).

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Hausken T, Ødegaard S, Matre K, Berstad A (1992). "Antroduodenal motility and movements of luminal contents studied by duplex sonography".

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Naftali T, Yishai R, Zangen T, Levine A (August 15, 2007). "Post-infectious gastroparesis: Clinical and electerogastrographic aspects".

533:, immunosuppression followed by viral infections involving the GI tract, procedures such as celiac blocks, paraneoplastic neuropathy or 223:, resulting in food and liquid remaining in the stomach for a prolonged period of time. Stomach contents thus exit more slowly into the 670:

Loss of gastric neurons containing nitric oxide synthase (NOS) is responsible for defective accommodation reflex, which leads to early

4855: 4262: 3066: 565:, about 30–50% among long-standing diabetics. In fact, diabetes mellitus has been named as the most common cause of gastroparesis, as 1327:. 4th Edition. 530 Walnut Street, Philadelphia, PA 19106 USA:Lippincott Williams & Wilkins; 2014. Available from: Books@Ovid at 687:

Abnormal pacemaker activity (tachybradyarrhythmia) may generate a noxious signal transmitted to the CNS to evoke nausea and vomiting.

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Dietary modifications, medications to stimulate gastric emptying, medications to reduce vomiting, and gastric electrical stimulation.

5527: 5374: 3443: 774: 5272: 720: 1959: 719:-bound, low-fat meal within 10 minutes of this test. A longer ingestion time may alter the results. Most medical facilities use 5413: 5025: 5008: 4513: 4508: 4385: 964: 793: 763: 4538: 629:

of records from the TriNetX database found that the number of patients diagnosed with gastroparesis after being prescribed a

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Davis MP, Weller R, Regel S (2018). "Gastroparesis and Cancer-Related Gastroparesis". In MacLeod RD, van den Block L (eds.).

1012: 301: 165: 5478: 1979: 618:, and other ailments have been anecdotally linked to the onset of the condition, but no systematic study has proven a link. 2186:"People using popular drugs for weight loss, diabetes are more likely to be diagnosed with stomach paralysis, studies find" 5324: 709: 1114: 5233: 4752: 4360: 3775:"The Incidence, Prevalence, and Outcomes of Patients With Gastroparesis in Olmsted County, Minnesota, From 1996 to 2006" 1396:"The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006" 293:. Patient nutritional state should be managed by oral dietary modification, or if oral intake is not adequate through a 4447: 1770:

Levin A, Levine M, Rubesin S, Laufer I (2008). "An 8-year review of barium studies in the diagnosis of gastroparesis".

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patients. Physical examination in patients with gastroparesis may be completely normal, or in its more severe forms,

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Kong MF, Horowitz M, Jones KL, Wishart JM, Harding PE (March 1, 1999). "Natural history of diabetic gastroparesis".

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Schwizer W, Maecke H, Michael F (1992). "Measurement of gastric emptying by magnetic resonance imaging in humans".

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or pain is common, affecting 90% of gastroparesis patients. Idiopathic gastroparesis patients may experience more

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Reddy SC, Wo JM (August 24, 2011). "Clinical Presentations of Gastroparesis". In Parkman HP, McCallum RW (eds.).

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Thorn AR (March 2010). "Not just another case of nausea and vomiting: a review of postinfectious gastroparesis".

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affected being women, while another study found the patients were young or middle aged and up to 90% were women.

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Sullivan A, Temperley L, Ruban A (30 April 2020). "Pathophysiology, Aetiology and Treatment of Gastroparesis".

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Griffith G, Owen G, Kirkman S, Shields R (1966). "Measurement of Rate of Gastric Emptying Using Chromium-51".

3832:"Viral gastroparesis: a subgroup of idiopathic gastroparesis—clinical characteristics and long-term outcomes" 5357: 5134: 4875: 4667: 4326: 976:

the circular pylorus muscle. This can be done laparoscopically or endoscopically (called G-POEM). Vertical

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up to and out of the mouth. Some patients may experience retching without gastric contents being expelled.

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is a major cause of this nerve damage; other causes include post-infectious and trauma to the vagus nerve.

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Gastroparesis can lead to difficult glycemic control (which exacerbates gastric dysmotility), aspiration,

282: 143:, abdominal or esophageal surgery, infection, certain medications that slow the rate of stomach emptying, 103: 654:

and other organs may not be able to function properly. Other important components of the stomach are the

5369: 5277: 5238: 5166: 1667:"National Survey of Physicians' Perception of the Cause, Complications, and Management of Gastroparesis" 743:. After that, the 13C-labeled substrate is attached to a food that can be digested, like muffins, or to 590: 5288: 4469: 3386: 3071:"Postprandial antropyloroduodenal motility and gastric emptying in gastroparesis—effects of cisapride" 1342:"Pregnancy and Delivery in a Woman with Type 1 Diabetes, Gastroparesis, and a Gastric Neurostimulator" 1181:

Owyang C (October 2011). "Phenotypic switching in diabetic gastroparesis: mechanism directs therapy".

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Long-term studies in gastroparesis patients show that it is not a benign disease and has significant

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Some evidence suggests that postviral gastroparesis has a better prognosis and lasts less time than

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Symptoms include nausea, vomiting, abdominal pain, feeling full soon after beginning to eat (early

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Tang DM, Friedenberg FK (2011). "Gastroparesis: Approach, Diagnostic Evaluation, and Management".

5514: 5379: 5362: 5347: 5334: 5317: 5183: 4710: 4682: 4442: 4338: 4303: 4222: 4002:"Gastroparesis and Functional Dyspepsia: A Blurring Distinction of Pathophysiology and Treatment" 3712: 3314: 3220: 3044: 2993: 2941: 2721: 2670: 2619: 2390: 2241: 2120: 1846: 1702: 1588: 1538: 1371: 1252: 1055: 977: 933: 381: 73: 4818: 4616: 2798:

Rao SS, Camilleri M, Hasler WL, Maurer AH, Parkman HP, Saad R, et al. (December 7, 2010).

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Jung HK, Choung RS, Locke GR, Schleck CD, Zinsmeister AR, Szarka LA, et al. (April 2009).

800:. The capsule is 26.8 mm long and 11.7 mm wide, and it contains three sensors for temperature, 645:

On the molecular level, it is thought that gastroparesis can be caused by the loss of neuronal

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Reddymasu SC, McCallum RW (2010). "Small Intestinal Bacterial Overgrowth in Gastroparesis".

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In specific cases where treatment of chronic nausea and vomiting proves resistant to drugs,

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channel in order to obtain information about gastric and duodenal contractions. Fasting and

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The stable isotope breath test is unreliable for individuals with small bowel diseases like

724: 678: 525: 232: 66: 2453:"Gastroduodenal motility and dysmotility: an update on techniques available for evaluation" 1923:"Idiopathic gastroparesis is associated with a multiplicity of severe dietary deficiencies" 1564: 1455: 5497: 5427: 5293: 5228: 5193: 5064: 4929: 4865: 4767: 4686: 4677: 4627: 4567: 4452: 4429: 1004: 697: 611: 598: 562: 558: 513: 497: 469: 399: 325: 228: 211: – gaster, "stomach"; and -paresis, πάρεσις – "partial paralysis"), also called 4254: 3773:

Jung HK, Choung RS, Locke GR, Schleck CD, Zinsmeister AR, Szarka LA, et al. (2009).

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reveals a large amount of material in the stomach, suggesting severe gastric hypomotility

3553:"Mirtazapine for severe gastroparesis unresponsive to conventional prokinetic treatment" 5534: 5449: 5003: 4976: 4841: 4776: 4772: 4662: 4632: 4211: 4036: 4001: 3983: 3966: 3948: 3923: 3894: 3869: 3807: 3774: 3528: 3501: 3477: 3460: 3164: 3129: 3105: 3070: 2875: 2858: 2775: 2740: 2339: 2312: 2288: 2263: 1898: 1865: 1420: 1395: 1301: 1276: 1275:

Camilleri M, Kuo B, Nguyen L, Vaughn VM, Petrey J, Greer K, et al. (August 2022).

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Parkman HP, Yates KP, Hasler WL, Nguyan L, Pasricha PJ, Snape WJ, et al. (2011).

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gastroparesis has been linked to a higher survival rate than diabetic gastroparesis.

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after feeding and after the stomach has been emptied. It is then transported to the

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Pace LA (November 9, 2019). "Etiology and Clinical Presentation of Gastroparesis".

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Cline M, Rouphael C (November 9, 2019). "Diagnostic Evaluation of Gastroparesis".

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Bharadwaj S, Meka K, Tandon P, Rathur A, Rivas JM, Vallabh H, et al. (2016).

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feeding. 26% of these patients failed to respond to medical treatment, and 6% had

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and poor glycemic control may be the only symptoms of delayed gastric emptying in

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Quigley EM, Donovan JP, Lane MJ, Gallagher TF (1992). "Antroduodenal manometry".

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is known to improve emptying of the stomach but its effects are temporary due to

5522: 5284: 5262: 5093: 5013: 4657: 4558: 4311: 4228: 4184: 2376: 2003: 1984: 1964: 1574: 1496: 1494: 1492: 1465: 1119: 949: 937: 921: 859: 855: 851: 820: 716: 574: 443: 427: 420: 416: 360:, however, morning or persistent nausea may occur. Vomiting is characterized by 342: 274: 247: 216: 177: 144: 135: 123: 30: 4154: 3060: 3058: 2451:

Parkman HP, Harris AD, Krevsky B, Urbain JL, Maurer AH, Fisher RS (June 1995).

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Bouras EP, Vazquez Roque MI, Aranda-Michel J (June 24, 2013). "Gastroparesis".

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Gastroparesis has also been associated with connective tissue diseases such as

5298: 4971: 4949: 4594: 4533: 4195: 4117: 3885: 3692: 3569: 3552: 3502:"Rapid improvement in post-infectious gastroparesis symptoms with mirtazapine" 3146: 1634: 1617: 878: 873: 866:

may move from the pylorus while an individual is fed and the stomach dilates.

828: 736: 684:

Sensory neuropathy in the gastric wall may be responsible for epigastric pain.

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is responsible for delayed gastric emptying, resulting in nausea and vomiting.

550: 4027: 3798: 3751: 3743: 3700: 3657: 3518: 3353: 3302: 3259: 3208: 3155: 3096: 3032: 3011:

Soffer E, Thongsawat S (1996). "Clinical value of duodenojejunal manometry".

2981: 2929: 2859:"A Technical Review and Clinical Assessment of the Wireless Motility Capsule" 2835: 2766: 2709: 2658: 2607: 2564: 2521: 2429: 2329: 2313:"The importance of interstitial cells of cajal in the gastrointestinal tract" 2279: 2108: 1889: 1834: 1791: 1748: 1740: 1690: 1643: 1526: 5248: 5218: 5081: 5059: 4912: 4763: 4737: 4599: 4589: 4476: 4437: 4370: 4200: 4160: 1518: 1043: 1016: 992: 953: 941: 732: 606: 334: 4045: 3992: 3957: 3903: 3831: 3816: 3759: 3665: 3605: 3578: 3537: 3486: 3310: 3173: 2989: 2937: 2884: 2843: 2784: 2717: 2666: 2615: 2572: 2529: 2489: 2487: 2485: 2452: 2348: 2297: 2237: 2228: 2163: 2116: 1922: 1907: 1842: 1799: 1756: 1698: 1651: 1534: 1429: 1367: 1310: 1248: 1202: 426:

Some patients may experience severe nausea and vomiting, which can lead to

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than diabetic gastroparesis patients. Physicians believe that postprandial

3847: 3708: 3361: 3267: 3216: 3114: 3040: 2468: 2437: 1938: 1449: 1447: 1445: 1443: 1441: 1439: 4882: 4860: 4572: 4233: 3939: 3625:. Proceedings 12th world congress of endoscopic surgery. pp. 14–17). 3087: 2920: 2826: 2362: 2360: 2358: 1039: 863: 847: 836: 786: 750: 534: 489: 465: 377: 361: 338: 317: 313: 242:), abdominal bloating, and heartburn. The most common known mechanism is 224: 140: 82: 3140:(3). The Korean Society of Neurogastroenterology and Motility: 395–404. 4934: 4700: 4604: 4576: 3551:

Kim SW, Shin IS, Kim JM, Kang HC, Mun JU, Yang SJ, et al. (2006).

3200: 3024: 2264:"Recent advances in the pathophysiology and treatment of gastroparesis" 2042:"Gastroparesis – Your Guide to Gastroparesis – Causes of Gastroparesis" 1028: 957: 832: 509: 473: 365: 321: 239: 220: 4085: 4012:(1). The Korean Society of Neurogastroenterology and Motility: 27–35. 3922:

Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L (January 2013).

2973: 2757: 1358: 1341: 168:(WMC), serial X-ray after ingesting radiopaque markers (ROM), gastric 5400: 5018: 4904: 4112: 4097: 4067:

National Institute of Diabetes, Digestive, and Kidney Diseases at NIH

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in nature, with unknown causes. It is, however, frequently caused by

493: 412: 373: 329: 286: 107: 78: 766:. For a total of 4–6 hours, samples are collected every 30 minutes. 472:. Furthermore, many individuals with gastroparesis are treated with 456:

There is a strong link between gastroparesis and the development of

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and a poor prognosis due to the limited options for treatment. The

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abdominal pain is unrelated to the impairment of gastric emptying.

4850: 4580: 4165: 4064: 945: 805: 758: 754: 215:, is a medical disorder consisting of weak muscular contractions ( 39: 731:

The stable isotope breath test involves using the stable isotope

658:(ICC) which act as a pacemaker since they transduce signals from 4217: 1389: 1387: 1385: 481: 4258: 3622:

Sleeve gastrectomy for the treatment of diabetic gastroparesis

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Briley LC, Harrell SP, Woosley A, Eversmann J, Wo JM (2011).

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Pathogenesis of symptoms in diabetic gastroparesis include:

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are highest. Neither theory has been proven definitively.

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By measuring changes in the antral area, two-dimensional

1821:(1). Ovid Technologies (Wolters Kluwer Health): e8–e13. 1323:. In: Simpson, Kathleen Rice, Creehan, Patricia A. eds. 846:

Antroduodenal manometry aids in differentiating between

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Bityutskiy LP, Soykan I, McCallum RW (September 1997).

3019:(5). Springer Science and Business Media LLC: 859–863. 1618:"Abdominal Pain Is a Frequent Symptom of Gastroparesis" 1229:

Journal of the American Academy of Nurse Practitioners

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gastroparesis is associated with an increased risk of

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balance, and inadequate nutrition intake resulting in

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Cherian D, Sachdeva P, Fisher RS, Parkman HP (2010).

1503:"Management of gastroparesis-associated malnutrition" 364:

and forceful evacuation of gastric contents from the

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Ogorek CP, Davidson L, Fisher RS, Krevsky B (1991).

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American Diabetes Association: 2667–2673. 839:states are used to measure the pressure of the 257:Diagnosis is via one or more of the following: 246:of the nerve which innervates the stomach: the 3434:Rang HP, Dale MM, Ritter JM, Moore PK (2003). 3385:. Medtronic. 29 September 2014. Archived from 932:and wane after a few weeks of consistent use. 376:after eating. It is the inverse of hunger and 281:, fatigue, weight loss, vitamin deficiencies, 147:, nervous system diseases, and hypothyroidism. 102:, fatigue, weight loss, vitamin deficiencies, 4270: 4006:Journal of Neurogastroenterology and Motility 3738:(3). American Diabetes Association: 503–507. 3134:Journal of Neurogastroenterology and Motility 2869:(12). Millenium Medical Publishing: 795–804. 2268:Journal of Neurogastroenterology and Motility 627:University Hospitals Cleveland Medical Center 8: 4376:Esophagogastric junction outflow obstruction 3594:Bariatric Surgical Practice and Patient Care 3373: 3371: 1677:(6). 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The 10 patients who died succumbed to 762:samples are collected and analyzed using 5565:Congenital disorders of digestive system 3928:The American Journal of Gastroenterology 3836:The American Journal of Gastroenterology 3069:, Maddox AF, Dent J (February 1, 1994). 2639:Scandinavian Journal of Gastroenterology 2588:The American Journal of Gastroenterology 2457:The American Journal of Gastroenterology 1927:The American Journal of Gastroenterology 1622:Clinical Gastroenterology and Hepatology 1281:The American Journal of Gastroenterology 1132: 1130: 126:, chemotherapy-induced neuropathy, and 3461:"Sildenafil may help diabetic patients" 1277:"ACG Clinical Guideline: Gastroparesis" 1081: 712:(GES) being the current gold standard. 2739:Shin AS, Camilleri M (July 17, 2013). 581:, and neurological conditions such as 446:feeding access to bypass the stomach. 415:formation, abnormalities in fluid and 4643:Small intestinal bacterial overgrowth 3379:"Treatment Options for Gastroparesis" 2257: 2255: 2044:. Heartburn.about.com. Archived from 524:Transient gastroparesis may arise in 458:small intestinal bacterial overgrowth 7: 3283:American Journal of Gastroenterology 2962:Neurogastroenterology & Motility 2900:Neurogastroenterology & Motility 2804:Neurogastroenterology & Motility 2690:Neurogastroenterology & Motility 2645:(7–8). Informa UK Limited: 852–861. 1815:Journal of Clinical Gastroenterology 1270: 1268: 1266: 1176: 1174: 1172: 1170: 1168: 1166: 1115:"Gastroparesis Causes – Mayo Clinic" 1109: 1107: 1105: 1103: 496:are commonly reported deficiencies. 291:small intestine bacterial overgrowth 112:small intestine bacterial overgrowth 2262:Oh JH, Pasricha PJ (January 2013). 2021:Jackson Siegelbaum Gastroenterology 356:Nausea in gastroparesis is usually 4000:Kim BJ, Kuo B (January 30, 2019). 948:) as does the popular anti-emetic 14: 5528:Spontaneous bacterial peritonitis 5375:Exocrine pancreatic insufficiency 3971:Gastroenterology & Hepatology 3506:World Journal of Gastroenterology 2863:Gastroenterology & Hepatology 2317:Saudi Journal of Gastroenterology 815:Antroduodenal manometry involves 775:exocrine pancreatic insufficiency 539:allogeneic bone marrow transplant 464:production are believed to allow 312:Gastroparesis has been linked to 5273:Secondary sclerosing cholangitis 3295:10.1111/j.1572-0241.2000.03346.x 2912:10.1111/j.1365-2982.2010.01468.x 2817:10.1111/j.1365-2982.2010.01612.x 2702:10.1046/j.1365-2982.2003.00397.x 2600:10.1111/j.1572-0241.2000.02076.x 2416:(7449). 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Elsevier BV: 486–498.e7. 1729:Nutrition in Clinical Practice 1340:Fuglsang J, Ovesen PG (2015). 1330:. Retrieved November 09, 2020. 1038:Other research indicates that 1013:gastric electrical stimulation 700:has been performed to exclude 302:gastric electrical stimulation 261:X-ray, barium beefsteak meal, 160:X-ray, barium beefsteak meal, 1: 5325:Sphincter of Oddi dysfunction 3785:(4). Elsevier BV: 1225–1233. 3246:(5). Elsevier BV: 1583–1590. 2506:(5). Elsevier BV: 1592–1622. 2422:10.1016/s0140-6736(66)90247-9 1507:Journal of Digestive Diseases 1406:(4). Elsevier BV: 1225–1233. 1293:10.14309/ajg.0000000000001874 710:gastric emptying scintigraphy 164:gastric-emptying scan (GES), 5234:Postcholecystectomy syndrome 4753:Intestinal pseudoobstruction 4361:Esophageal motility disorder 3791:10.1053/j.gastro.2008.12.047 3650:10.1053/j.gastro.2009.04.055 3346:10.1016/0016-5085(92)90823-h 3252:10.1016/0016-5085(92)91717-i 2651:10.3109/00365521.2010.483740 2513:10.1053/j.gastro.2004.09.055 2069:. MayoClinic.com. 2012-01-04 1882:10.1053/j.gastro.2011.04.045 1827:10.1097/mcg.0b013e3181aec746 1683:10.1097/smj.0b013e318215fa5a 1412:10.1053/j.gastro.2008.12.047 1195:10.1053/j.gastro.2011.08.014 999:is highest in patients with 589:. It may occur as part of a 567:high levels of blood glucose 205:(gastro- from Ancient Greek 53:(/,ɡæstroʊ,pəˈriːsɪs/) 3644:(2). Elsevier BV: 445–452. 3340:(2). Elsevier BV: 369–376. 2857:Saad RJ, Hasler WL (2011). 2377:10.1007/978-3-030-28929-4_3 1778:(4). Elsevier BV: 407–414. 1628:(8). Elsevier BV: 676–681. 1575:10.1007/978-3-030-28929-4_2 1466:10.1007/978-1-60761-552-1_3 1139:Textbook of Palliative Care 900:Dietary treatment involves 656:interstitial cells of Cajal 5586: 5219:Gallstone / Cholelithiasis 4743:Functional colonic disease 4539:Zollinger–Ellison syndrome 3868:Bharucha AE (March 2015). 3459:Gottlieb S (August 2000). 2906:(5). Wiley: 527–33, e117. 2551:(2). Elsevier BV: 74–101. 2220:10.1007/s10620-020-06287-2 2162:. Oley.org. Archived from 1784:10.1016/j.crad.2007.10.007 1325:AWHONN's Perinatal Nursing 971:is implanted that applies 885:Another appealing tool is 706:gastric outlet obstruction 674:and postprandial fullness. 275:stable isotope breath test 271:esophagogastroduodenoscopy 206: 178:stable isotope breath test 174:esophagogastroduodenoscopy 4420:Acute esophageal necrosis 3886:10.1016/j.gtc.2014.11.002 3570:10.1176/appi.psy.47.5.440 3147:10.5056/jnm.2013.19.3.395 2184:Goodman B (20 May 2024). 1635:10.1016/j.cgh.2010.04.027 543:graft-versus-host disease 166:wireless motility capsule 37: 28: 4519:Gastric dumping syndrome 4394:Laryngopharyngeal reflux 4381:Diffuse esophageal spasm 3744:10.2337/diacare.22.3.503 3519:10.3748/wjg.v20.i21.6671 2330:10.4103/1319-3767.105909 2280:10.5056/jnm.2013.19.1.18 1741:10.1177/0884533613491982 1671:Southern Medical Journal 1094:dictionary.cambridge.org 735:(13C) in a medium-chain 637:Physiology and mechanism 440:nutritional deficiencies 277:. Complications include 213:delayed gastric emptying 5135:Alcoholic liver disease 4668:Bile acid malabsorption 4612:Peptic (duodenal) ulcer 3693:10.1023/a:1026665728213 2095:(9). Wiley: 1423–1428. 2067:"Gastroparesis: Causes" 1519:10.1111/1751-2980.12344 587:multiple system atrophy 432:orthostatic hypotension 5145:Hepatic encephalopathy 4529:Buried bumper syndrome 4460:Peptic (gastric) ulcer 4344:Mallory–Weiss syndrome 4287:human digestive system 3606:10.1089/bari.2015.0052 2141:. Online.epocrates.com 819:or under radiographic 631:GLP-1 receptor agonist 579:Ehlers–Danlos syndrome 474:acid-suppressive drugs 283:intestinal obstruction 104:intestinal obstruction 5370:Pancreatic pseudocyst 5239:Porcelain gallbladder 4351:Zenker's diverticulum 3934:(1): 18–37, quiz 38. 2696:(2). Wiley: 113–120. 2311:Al-Shboul OA (2013). 1735:(4). Wiley: 437–447. 1513:(5). Wiley: 285–294. 1035:caused by adhesions. 591:mitochondrial disease 5174:Hepatorenal syndrome 5113:Budd–Chiari syndrome 5070:Autoimmune hepatitis 4895:Intestinal adhesions 4653:Short bowel syndrome 4482:Functional dyspepsia 4400:Esophageal stricture 4366:Nutcracker esophagus 3940:10.1038/ajg.2012.373 3088:10.1136/gut.35.2.172 785:because it involves 721:99mTc sulfur colloid 702:peptic ulcer disease 555:autonomic neuropathy 486:fat-soluble vitamins 392:Abdominal discomfort 244:autonomic neuropathy 128:autonomic neuropathy 5313:Choledocholithiasis 5184:Metabolic disorders 5150:Acute liver failure 5123:Portal hypertension 5075:Alcoholic hepatitis 4918:Radiation proctitis 4837:Mesenteric ischemia 4809:Gastroenterocolitis 4638:Blind loop syndrome 4448:Ménétrier's disease 4356:Barrett's esophagus 3081:(2). BMJ: 172–178. 1046:yet not mortality. 746:Spirulina platensis 583:Parkinson's disease 436:renal insufficiency 5488:Undefined location 5479:Grynfeltt–Lesshaft 5380:Pancreatic fistula 5363:Pancreatic abscess 5318:Biliary dyskinesia 5289:Mirizzi's syndrome 4790:Large and/or small 4470:Dieulafoy's lesion 4339:Boerhaave syndrome 4176:External resources 3201:10.1007/bf01308337 3025:10.1007/bf02091523 2810:(1). Wiley: 8–23. 1772:Clinical Radiology 978:sleeve gastrectomy 934:Sildenafil citrate 739:substrate such as 430:, as evidenced by 308:Signs and symptoms 5570:Stomach disorders 5552: 5551: 5548: 5547: 5388: 5387: 4990: 4989: 4847:Bowel obstruction 4549: 4548: 4252: 4251: 3512:(21): 6671–6674. 2974:10.1111/nmo.13087 2758:10.2337/db12-1706 2386:978-3-030-28928-7 1584:978-3-030-28928-7 1475:978-1-60761-551-4 1359:10.2337/dc14-2959 1156:978-3-319-31738-0 753:and liquefies to 603:abdominal surgery 434:as well as acute 351:succussion splash 252:diabetes mellitus 200: 199: 196:possibly up to 4% 153:Diagnostic method 38:Simple abdominal 18:Medical condition 5577: 5540:Pneumoperitoneum 5397: 5307:Common bile duct 5189:Wilson's disease 5179:Peliosis hepatis 5048: 4925:Proctalgia fugax 4832:Abdominal angina 4757:Ogilvie syndrome 4706:Pseudomembranous 4564: 4524:Gastric volvulus 4489:Pyloric stenosis 4300: 4285:Diseases of the 4279: 4272: 4265: 4256: 4077: 4049: 4039: 4021: 4019:10.5056/jnm18162 3996: 3986: 3961: 3951: 3908: 3907: 3897: 3865: 3859: 3858: 3856: 3854: 3842:(9): 1501–1504. 3827: 3821: 3820: 3810: 3779:Gastroenterology 3770: 3764: 3763: 3727: 3721: 3720: 3676: 3670: 3669: 3638:Gastroenterology 3633: 3627: 3626: 3616: 3610: 3609: 3589: 3583: 3582: 3572: 3548: 3542: 3541: 3531: 3521: 3497: 3491: 3490: 3480: 3456: 3450: 3449: 3431: 3425: 3424: 3422: 3420: 3405: 3399: 3398: 3396: 3394: 3389:on 10 March 2016 3375: 3366: 3365: 3334:Gastroenterology 3329: 3323: 3322: 3278: 3272: 3271: 3240:Gastroenterology 3235: 3229: 3228: 3184: 3178: 3177: 3167: 3149: 3125: 3119: 3118: 3108: 3090: 3062: 3053: 3052: 3008: 3002: 3001: 2956: 2950: 2949: 2923: 2895: 2889: 2888: 2878: 2854: 2848: 2847: 2829: 2819: 2795: 2789: 2788: 2778: 2760: 2736: 2730: 2729: 2685: 2679: 2678: 2634: 2628: 2627: 2583: 2577: 2576: 2540: 2534: 2533: 2515: 2500:Gastroenterology 2491: 2480: 2479: 2477: 2475: 2448: 2442: 2441: 2405: 2399: 2398: 2364: 2353: 2352: 2342: 2332: 2308: 2302: 2301: 2291: 2259: 2250: 2249: 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67:Gastroenterology 33: 21: 5585: 5584: 5580: 5579: 5578: 5576: 5575: 5574: 5555: 5554: 5553: 5544: 5509: 5498:Internal hernia 5384: 5329: 5294:Biliary fistula 5252: 5243: 5229:Adenomyomatosis 5224:Cholesterolosis 5200: 5194:Hemochromatosis 5065:Viral hepatitis 5037: 4986: 4944: 4930:Rectal prolapse 4899: 4866:Fecal impaction 4856:Intussusception 4819:Crohn's disease 4785: 4768:Toxic megacolon 4680: 4678:Large intestine 4672: 4617:Curling's ulcer 4570: 4568:Small intestine 4557: 4545: 4453:Gastroenteritis 4424: 4289: 4283: 4253: 4248: 4247: 4171: 4170: 4088: 4057: 4052: 3999: 3964: 3921: 3917: 3915:Further reading 3912: 3911: 3867: 3866: 3862: 3852: 3850: 3829: 3828: 3824: 3772: 3771: 3767: 3729: 3728: 3724: 3678: 3677: 3673: 3635: 3634: 3630: 3618: 3617: 3613: 3591: 3590: 3586: 3550: 3549: 3545: 3499: 3498: 3494: 3458: 3457: 3453: 3446: 3433: 3432: 3428: 3418: 3416: 3407: 3406: 3402: 3392: 3390: 3377: 3376: 3369: 3331: 3330: 3326: 3280: 3279: 3275: 3237: 3236: 3232: 3186: 3185: 3181: 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1164: 1157: 1136: 1135: 1128: 1113: 1112: 1101: 1088: 1087: 1083: 1078: 1065: 1023:complications, 989: 967:may be used. A 916: 902:low fiber diets 895: 874:ultrasonography 698:upper endoscopy 694: 639: 625:An analysis by 612:Gastroenteritis 599:anticholinergic 563:type 2 diabetes 522: 514:caloric deficit 498:Iron deficiency 470:small intestine 409: 400:epigastric pain 349:, as well as a 326:epigastric pain 310: 250:. Uncontrolled 229:digestive tract 56: 19: 12: 11: 5: 5583: 5581: 5573: 5572: 5567: 5557: 5556: 5550: 5549: 5546: 5545: 5543: 5542: 5537: 5535:Hemoperitoneum 5532: 5531: 5530: 5519: 5517: 5511: 5510: 5508: 5507: 5506: 5505: 5500: 5495: 5484: 5483: 5482: 5481: 5476: 5463: 5462: 5457: 5452: 5447: 5442: 5441: 5440: 5435: 5424: 5423: 5418: 5417: 5416: 5405: 5403: 5394: 5390: 5389: 5386: 5385: 5383: 5382: 5377: 5372: 5367: 5366: 5365: 5360: 5355: 5350: 5339: 5337: 5331: 5330: 5328: 5327: 5322: 5321: 5320: 5315: 5302: 5301: 5296: 5291: 5282: 5281: 5280: 5275: 5270: 5259: 5257: 5245: 5244: 5242: 5241: 5236: 5231: 5226: 5221: 5216: 5210: 5208: 5202: 5201: 5199: 5198: 5197: 5196: 5191: 5181: 5176: 5171: 5170: 5169: 5164: 5154: 5153: 5152: 5147: 5137: 5132: 5131: 5130: 5125: 5120: 5115: 5103: 5102: 5101: 5091: 5090: 5089: 5079: 5078: 5077: 5072: 5067: 5056: 5054: 5045: 5039: 5038: 5036: 5035: 5034: 5033: 5023: 5022: 5021: 5016: 5006: 5004:Blood in stool 5000: 4998: 4992: 4991: 4988: 4987: 4985: 4984: 4979: 4977:Anal dysplasia 4974: 4969: 4964: 4954: 4952: 4946: 4945: 4943: 4942: 4937: 4932: 4927: 4922: 4921: 4920: 4909: 4907: 4901: 4900: 4898: 4897: 4892: 4891: 4890: 4880: 4879: 4878: 4868: 4863: 4858: 4853: 4844: 4842:Angiodysplasia 4839: 4834: 4823: 4822: 4821: 4811: 4806: 4805: 4804: 4793: 4791: 4787: 4786: 4784: 4783: 4777:Diverticulosis 4773:Diverticulitis 4770: 4761: 4760: 4759: 4750: 4740: 4735: 4734: 4733: 4728: 4723: 4718: 4713: 4708: 4698: 4692: 4690: 4674: 4673: 4671: 4670: 4665: 4663:Milroy disease 4660: 4655: 4650: 4645: 4640: 4635: 4633:Tropical sprue 4630: 4621: 4620: 4619: 4609: 4608: 4607: 4602: 4597: 4586: 4584: 4561: 4555:Lower GI tract 4551: 4550: 4547: 4546: 4544: 4543: 4542: 4541: 4531: 4526: 4521: 4516: 4511: 4506: 4501: 4496: 4491: 4486: 4485: 4484: 4474: 4473: 4472: 4467: 4457: 4456: 4455: 4450: 4445: 4434: 4432: 4426: 4425: 4423: 4422: 4417: 4412: 4407: 4402: 4397: 4391: 4390: 4389: 4383: 4378: 4373: 4368: 4358: 4353: 4348: 4347: 4346: 4341: 4331: 4330: 4329: 4324: 4319: 4308: 4306: 4297: 4295:Upper GI tract 4291: 4290: 4284: 4282: 4281: 4274: 4267: 4259: 4250: 4249: 4246: 4245: 4236: 4225: 4214: 4203: 4192: 4180: 4179: 4177: 4173: 4172: 4169: 4168: 4157: 4146: 4135: 4120: 4105: 4089: 4084: 4083: 4081: 4080:Classification 4074: 4073: 4068: 4056: 4055:External links 4053: 4051: 4050: 3997: 3962: 3918: 3916: 3913: 3910: 3909: 3860: 3822: 3765: 3722: 3671: 3628: 3611: 3584: 3563:(5): 440–442. 3557:Psychosomatics 3543: 3492: 3471:(7258): 401A. 3451: 3444: 3426: 3400: 3367: 3324: 3273: 3230: 3179: 3120: 3054: 3003: 2951: 2890: 2849: 2790: 2731: 2680: 2629: 2578: 2535: 2481: 2463:(6): 869–892. 2443: 2400: 2385: 2354: 2303: 2251: 2198: 2176: 2151: 2130: 2079: 2058: 2033: 2008: 1991: 1971: 1951: 1933:(4): 423–428. 1913: 1856: 1805: 1762: 1719: 1657: 1605: 1583: 1555: 1488: 1474: 1435: 1381: 1332: 1316: 1262: 1235:(3): 125–133. 1208: 1162: 1155: 1126: 1099: 1080: 1079: 1077: 1074: 1064: 1061: 1048:Olmsted County 1033:bowel ischemia 997:mortality rate 988: 985: 969:medical device 914: 909:Metoclopramide 894: 891: 817:endoscopically 771:celiac disease 693: 690: 689: 688: 685: 682: 675: 638: 635: 537:, or after an 521: 518: 408: 405: 396:abdominal pain 309: 306: 297:feeding tube. 259:barium swallow 198: 197: 194: 190: 189: 186: 182: 181: 158:Barium swallow 155: 149: 148: 138: 132: 131: 122:Damage to the 120: 116: 115: 97: 91: 90: 87:abdominal pain 76: 70: 69: 64: 58: 57: 55: 54: 50: 48: 44: 43: 35: 34: 26: 25: 17: 13: 10: 9: 6: 4: 3: 2: 5582: 5571: 5568: 5566: 5563: 5562: 5560: 5541: 5538: 5536: 5533: 5529: 5526: 5525: 5524: 5521: 5520: 5518: 5516: 5512: 5504: 5501: 5499: 5496: 5494: 5491: 5490: 5489: 5486: 5485: 5480: 5477: 5475: 5472: 5471: 5470: 5469: 5465: 5464: 5461: 5458: 5456: 5453: 5451: 5448: 5446: 5443: 5439: 5436: 5434: 5431: 5430: 5429: 5426: 5425: 5422: 5419: 5415: 5412: 5411: 5410: 5409:Diaphragmatic 5407: 5406: 5404: 5402: 5398: 5395: 5391: 5381: 5378: 5376: 5373: 5371: 5368: 5364: 5361: 5359: 5356: 5354: 5351: 5349: 5346: 5345: 5344: 5341: 5340: 5338: 5336: 5332: 5326: 5323: 5319: 5316: 5314: 5311: 5310: 5309: 5308: 5304: 5303: 5300: 5297: 5295: 5292: 5290: 5286: 5283: 5279: 5276: 5274: 5271: 5269: 5266: 5265: 5264: 5261: 5260: 5258: 5256: 5250: 5246: 5240: 5237: 5235: 5232: 5230: 5227: 5225: 5222: 5220: 5217: 5215: 5214:Cholecystitis 5212: 5211: 5209: 5207: 5203: 5195: 5192: 5190: 5187: 5186: 5185: 5182: 5180: 5177: 5175: 5172: 5168: 5165: 5163: 5160: 5159: 5158: 5157:Liver abscess 5155: 5151: 5148: 5146: 5143: 5142: 5141: 5140:Liver failure 5138: 5136: 5133: 5129: 5126: 5124: 5121: 5119: 5116: 5114: 5111: 5110: 5109: 5108: 5104: 5100: 5097: 5096: 5095: 5092: 5088: 5085: 5084: 5083: 5080: 5076: 5073: 5071: 5068: 5066: 5063: 5062: 5061: 5058: 5057: 5055: 5053: 5049: 5046: 5044: 5040: 5032: 5029: 5028: 5027: 5024: 5020: 5017: 5015: 5012: 5011: 5010: 5007: 5005: 5002: 5001: 4999: 4997: 4993: 4983: 4980: 4978: 4975: 4973: 4970: 4968: 4965: 4963: 4959: 4956: 4955: 4953: 4951: 4947: 4941: 4938: 4936: 4933: 4931: 4928: 4926: 4923: 4919: 4916: 4915: 4914: 4911: 4910: 4908: 4906: 4902: 4896: 4893: 4889: 4886: 4885: 4884: 4881: 4877: 4874: 4873: 4872: 4869: 4867: 4864: 4862: 4859: 4857: 4854: 4852: 4848: 4845: 4843: 4840: 4838: 4835: 4833: 4829: 4828: 4824: 4820: 4817: 4816: 4815: 4812: 4810: 4807: 4803: 4800: 4799: 4798: 4797:Enterocolitis 4795: 4794: 4792: 4788: 4782: 4778: 4774: 4771: 4769: 4765: 4762: 4758: 4754: 4751: 4749: 4746: 4745: 4744: 4741: 4739: 4736: 4732: 4729: 4727: 4724: 4722: 4719: 4717: 4714: 4712: 4709: 4707: 4704: 4703: 4702: 4699: 4697: 4694: 4693: 4691: 4688: 4684: 4679: 4675: 4669: 4666: 4664: 4661: 4659: 4656: 4654: 4651: 4649: 4646: 4644: 4641: 4639: 4636: 4634: 4631: 4629: 4625: 4624:Malabsorption 4622: 4618: 4615: 4614: 4613: 4610: 4606: 4603: 4601: 4598: 4596: 4593: 4592: 4591: 4588: 4587: 4585: 4582: 4578: 4574: 4569: 4565: 4562: 4560: 4556: 4552: 4540: 4537: 4536: 4535: 4532: 4530: 4527: 4525: 4522: 4520: 4517: 4515: 4512: 4510: 4507: 4505: 4502: 4500: 4499:Gastroparesis 4497: 4495: 4492: 4490: 4487: 4483: 4480: 4479: 4478: 4475: 4471: 4468: 4466: 4465:Cushing ulcer 4463: 4462: 4461: 4458: 4454: 4451: 4449: 4446: 4444: 4441: 4440: 4439: 4436: 4435: 4433: 4431: 4427: 4421: 4418: 4416: 4413: 4411: 4410:Megaesophagus 4408: 4406: 4403: 4401: 4398: 4395: 4392: 4387: 4384: 4382: 4379: 4377: 4374: 4372: 4369: 4367: 4364: 4363: 4362: 4359: 4357: 4354: 4352: 4349: 4345: 4342: 4340: 4337: 4336: 4335: 4332: 4328: 4325: 4323: 4320: 4318: 4315: 4314: 4313: 4310: 4309: 4307: 4305: 4301: 4298: 4296: 4292: 4288: 4280: 4275: 4273: 4268: 4266: 4261: 4260: 4257: 4244: 4240: 4237: 4235: 4231: 4230: 4226: 4224: 4223:Gastroparesis 4220: 4219: 4215: 4213: 4212:Gastroparesis 4209: 4208: 4204: 4202: 4201:Gastroparesis 4198: 4197: 4193: 4191: 4187: 4186: 4182: 4181: 4178: 4174: 4167: 4163: 4162: 4158: 4156: 4152: 4151: 4147: 4145: 4141: 4140: 4136: 4134: 4130: 4129: 4125: 4121: 4119: 4115: 4114: 4110: 4106: 4104: 4100: 4099: 4095: 4091: 4090: 4087: 4082: 4078: 4071: 4069: 4066: 4062: 4059: 4058: 4054: 4047: 4043: 4038: 4033: 4029: 4025: 4020: 4015: 4011: 4007: 4003: 3998: 3994: 3990: 3985: 3980: 3976: 3972: 3968: 3963: 3959: 3955: 3950: 3945: 3941: 3937: 3933: 3929: 3925: 3920: 3919: 3914: 3905: 3901: 3896: 3891: 3887: 3883: 3879: 3875: 3871: 3864: 3861: 3849: 3845: 3841: 3837: 3833: 3826: 3823: 3818: 3814: 3809: 3804: 3800: 3796: 3792: 3788: 3784: 3780: 3776: 3769: 3766: 3761: 3757: 3753: 3749: 3745: 3741: 3737: 3733: 3732:Diabetes Care 3726: 3723: 3718: 3714: 3710: 3706: 3702: 3698: 3694: 3690: 3686: 3682: 3675: 3672: 3667: 3663: 3659: 3655: 3651: 3647: 3643: 3639: 3632: 3629: 3624: 3623: 3615: 3612: 3607: 3603: 3599: 3595: 3588: 3585: 3580: 3576: 3571: 3566: 3562: 3558: 3554: 3547: 3544: 3539: 3535: 3530: 3525: 3520: 3515: 3511: 3507: 3503: 3496: 3493: 3488: 3484: 3479: 3474: 3470: 3466: 3462: 3455: 3452: 3447: 3445:0-443-07145-4 3441: 3437: 3430: 3427: 3414: 3410: 3404: 3401: 3388: 3384: 3383:Medtronic.com 3380: 3374: 3372: 3368: 3363: 3359: 3355: 3351: 3347: 3343: 3339: 3335: 3328: 3325: 3320: 3316: 3312: 3308: 3304: 3300: 3296: 3292: 3288: 3284: 3277: 3274: 3269: 3265: 3261: 3257: 3253: 3249: 3245: 3241: 3234: 3231: 3226: 3222: 3218: 3214: 3210: 3206: 3202: 3198: 3194: 3190: 3183: 3180: 3175: 3171: 3166: 3161: 3157: 3153: 3148: 3143: 3139: 3135: 3131: 3124: 3121: 3116: 3112: 3107: 3102: 3098: 3094: 3089: 3084: 3080: 3076: 3072: 3068: 3061: 3059: 3055: 3050: 3046: 3042: 3038: 3034: 3030: 3026: 3022: 3018: 3014: 3007: 3004: 2999: 2995: 2991: 2987: 2983: 2979: 2975: 2971: 2967: 2963: 2955: 2952: 2947: 2943: 2939: 2935: 2931: 2927: 2922: 2921:2027.42/78624 2917: 2913: 2909: 2905: 2901: 2894: 2891: 2886: 2882: 2877: 2872: 2868: 2864: 2860: 2853: 2850: 2845: 2841: 2837: 2833: 2828: 2827:2027.42/79321 2823: 2818: 2813: 2809: 2805: 2801: 2794: 2791: 2786: 2782: 2777: 2772: 2768: 2764: 2759: 2754: 2750: 2746: 2742: 2735: 2732: 2727: 2723: 2719: 2715: 2711: 2707: 2703: 2699: 2695: 2691: 2684: 2681: 2676: 2672: 2668: 2664: 2660: 2656: 2652: 2648: 2644: 2640: 2633: 2630: 2625: 2621: 2617: 2613: 2609: 2605: 2601: 2597: 2593: 2589: 2582: 2579: 2574: 2570: 2566: 2562: 2558: 2554: 2550: 2546: 2539: 2536: 2531: 2527: 2523: 2519: 2514: 2509: 2505: 2501: 2497: 2490: 2488: 2486: 2482: 2470: 2466: 2462: 2458: 2454: 2447: 2444: 2439: 2435: 2431: 2427: 2423: 2419: 2415: 2411: 2404: 2401: 2396: 2392: 2388: 2382: 2378: 2374: 2370: 2369:Gastroparesis 2363: 2361: 2359: 2355: 2350: 2346: 2341: 2336: 2331: 2326: 2322: 2318: 2314: 2307: 2304: 2299: 2295: 2290: 2285: 2281: 2277: 2273: 2269: 2265: 2258: 2256: 2252: 2247: 2243: 2239: 2235: 2230: 2229:10044/1/79544 2225: 2221: 2217: 2213: 2209: 2202: 2199: 2187: 2180: 2177: 2166:on 2005-12-12 2165: 2161: 2155: 2152: 2140: 2134: 2131: 2126: 2122: 2118: 2114: 2110: 2106: 2102: 2098: 2094: 2090: 2083: 2080: 2068: 2062: 2059: 2048:on 2012-03-23 2047: 2043: 2037: 2034: 2022: 2018: 2012: 2009: 2005: 2002:(magazine of 2001: 1995: 1992: 1987: 1986: 1981: 1975: 1972: 1967: 1966: 1961: 1955: 1952: 1940: 1936: 1932: 1928: 1924: 1917: 1914: 1909: 1905: 1900: 1895: 1891: 1887: 1883: 1879: 1875: 1871: 1867: 1860: 1857: 1852: 1848: 1844: 1840: 1836: 1832: 1828: 1824: 1820: 1816: 1809: 1806: 1801: 1797: 1793: 1789: 1785: 1781: 1777: 1773: 1766: 1763: 1758: 1754: 1750: 1746: 1742: 1738: 1734: 1730: 1723: 1720: 1708: 1704: 1700: 1696: 1692: 1688: 1684: 1680: 1676: 1672: 1668: 1661: 1658: 1653: 1649: 1645: 1641: 1636: 1631: 1627: 1623: 1619: 1612: 1610: 1606: 1594: 1590: 1586: 1580: 1576: 1572: 1568: 1567: 1566:Gastroparesis 1559: 1556: 1544: 1540: 1536: 1532: 1528: 1524: 1520: 1516: 1512: 1508: 1504: 1497: 1495: 1493: 1489: 1477: 1471: 1467: 1463: 1459: 1458: 1457:Gastroparesis 1450: 1448: 1446: 1444: 1442: 1440: 1436: 1431: 1427: 1422: 1417: 1413: 1409: 1405: 1401: 1397: 1390: 1388: 1386: 1382: 1377: 1373: 1369: 1365: 1360: 1355: 1351: 1347: 1346:Diabetes Care 1343: 1336: 1333: 1329: 1326: 1320: 1317: 1312: 1308: 1303: 1298: 1294: 1290: 1286: 1282: 1278: 1271: 1269: 1267: 1263: 1258: 1254: 1250: 1246: 1242: 1238: 1234: 1230: 1223: 1221: 1219: 1217: 1215: 1213: 1209: 1204: 1200: 1196: 1192: 1188: 1184: 1177: 1175: 1173: 1171: 1169: 1167: 1163: 1158: 1152: 1148: 1144: 1140: 1133: 1131: 1127: 1122: 1121: 1116: 1110: 1108: 1106: 1104: 1100: 1095: 1091: 1085: 1082: 1075: 1073: 1069: 1062: 1060: 1057: 1052: 1049: 1045: 1041: 1036: 1034: 1030: 1026: 1025:renal failure 1022: 1018: 1014: 1010: 1006: 1002: 1001:decompensated 998: 994: 986: 984: 981: 979: 974: 970: 966: 961: 959: 955: 951: 947: 943: 939: 935: 931: 930:tachyphylaxis 927: 923: 918: 911:, a dopamine 910: 906: 903: 898: 892: 890: 888: 883: 880: 875: 870: 867: 865: 861: 857: 853: 849: 844: 842: 838: 834: 830: 826: 822: 818: 813: 809: 807: 803: 799: 795: 790: 788: 784: 780: 779:liver disease 776: 772: 767: 765: 760: 756: 752: 748: 747: 742: 741:octanoic acid 738: 734: 729: 726: 722: 718: 713: 711: 707: 703: 699: 691: 686: 683: 680: 676: 673: 669: 668: 667: 664: 661: 660:motor neurons 657: 653: 652:smooth muscle 648: 643: 636: 634: 632: 628: 623: 619: 617: 616:mononucleosis 613: 608: 604: 600: 596: 592: 588: 584: 580: 576: 571: 568: 564: 560: 556: 552: 546: 544: 540: 536: 532: 527: 519: 517: 515: 511: 506: 505:blood glucose 501: 499: 495: 491: 487: 483: 477: 475: 471: 467: 463: 459: 454: 452: 447: 445: 441: 437: 433: 429: 424: 422: 418: 414: 407:Complications 406: 404: 401: 397: 393: 389: 385: 383: 379: 375: 369: 367: 363: 359: 354: 352: 348: 344: 340: 336: 331: 327: 323: 319: 315: 307: 305: 303: 298: 296: 292: 288: 284: 280: 276: 273:(EGD), and a 272: 268: 264: 260: 255: 253: 249: 245: 241: 236: 234: 230: 226: 222: 218: 214: 209: 204: 203:Gastroparesis 195: 191: 187: 183: 179: 176:(EGD), and a 175: 171: 167: 163: 159: 156: 154: 150: 146: 142: 139: 137: 133: 129: 125: 121: 117: 113: 109: 105: 101: 98: 96: 95:Complications 92: 88: 84: 80: 77: 75: 71: 68: 65: 63: 59: 52: 51: 49: 47:Pronunciation 45: 41: 36: 32: 27: 24:Gastroparesis 22: 16: 5487: 5466: 5343:Pancreatitis 5305: 5255:biliary tree 5128:Nutmeg liver 5105: 5031:Hematochezia 4982:Pruritus ani 4967:Anal abscess 4962:Anal fistula 4958:Anal fissure 4871:Constipation 4825: 4696:Appendicitis 4504:Gastroptosis 4498: 4494:Achlorhydria 4333: 4322:Eosinophilic 4238: 4227: 4216: 4205: 4194: 4183: 4159: 4148: 4137: 4122: 4107: 4092: 4009: 4005: 3974: 3970: 3931: 3927: 3877: 3873: 3863: 3851:. Retrieved 3839: 3835: 3825: 3782: 3778: 3768: 3735: 3731: 3725: 3684: 3680: 3674: 3641: 3637: 3631: 3621: 3614: 3597: 3593: 3587: 3560: 3556: 3546: 3509: 3505: 3495: 3468: 3464: 3454: 3436:Pharmacology 3435: 3429: 3417:. Retrieved 3412: 3403: 3391:. Retrieved 3387:the original 3382: 3337: 3333: 3327: 3286: 3282: 3276: 3243: 3239: 3233: 3192: 3188: 3182: 3137: 3133: 3123: 3078: 3074: 3016: 3012: 3006: 2968:(9). Wiley. 2965: 2961: 2954: 2903: 2899: 2893: 2866: 2862: 2852: 2807: 2803: 2793: 2748: 2744: 2734: 2693: 2689: 2683: 2642: 2638: 2632: 2591: 2587: 2581: 2548: 2544: 2538: 2503: 2499: 2472:. Retrieved 2460: 2456: 2446: 2413: 2409: 2403: 2368: 2320: 2316: 2306: 2274:(1): 18–24. 2271: 2267: 2211: 2207: 2201: 2190:. Retrieved 2179: 2168:. Retrieved 2164:the original 2154: 2143:. Retrieved 2133: 2092: 2088: 2082: 2071:. Retrieved 2061: 2050:. Retrieved 2046:the original 2036: 2025:. Retrieved 2023:. 2011-11-08 2020: 2011: 1999: 1994: 1983: 1974: 1963: 1954: 1942:. 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Retrieved 1456: 1403: 1399: 1349: 1345: 1335: 1324: 1319: 1284: 1280: 1232: 1228: 1186: 1182: 1138: 1118: 1093: 1084: 1070: 1066: 1053: 1037: 990: 982: 962: 926:Erythromycin 907: 899: 896: 884: 871: 868: 845: 837:postprandial 827:catheter or 823:inserting a 814: 810: 798:constipation 791: 783:lung disease 768: 744: 730: 714: 695: 665: 647:nitric oxide 644: 640: 624: 620: 572: 547: 523: 502: 478: 462:gastric acid 455: 448: 425: 410: 390: 386: 370: 358:postprandial 355: 347:malnutrition 311: 299: 279:malnutrition 263:radioisotope 256: 237: 212: 202: 201: 162:radioisotope 136:Risk factors 100:Malnutrition 15: 5523:Peritonitis 5285:Cholestasis 5263:Cholangitis 5206:Gallbladder 5094:Fatty liver 5014:Hematemesis 4996:GI bleeding 4802:Necrotizing 4731:Lymphocytic 4726:Collagenous 4721:Microscopic 4658:Steatorrhea 4559:Enteropathy 4405:Inlet patch 4327:Herpetiform 4312:Esophagitis 4229:Radiopaedia 4185:MedlinePlus 3977:(6): 1–16. 3880:(1): 9–19. 3853:20 November 3600:(2): 84–9. 3065:Fraser RJ, 2474:20 November 2323:(1): 3–15. 2004:Diabetes UK 1985:Mayo Clinic 1965:Mayo Clinic 1944:20 November 1712:20 November 1598:20 November 1548:20 November 1481:20 November 1120:Mayo Clinic 950:ondansetron 938:mirtazapine 922:domperidone 860:neuropathic 856:amyloidosis 852:scleroderma 821:fluoroscopy 717:radiotracer 575:scleroderma 444:small bowel 428:dehydration 421:weight loss 417:electrolyte 343:dehydration 295:jejunostomy 248:vagus nerve 217:peristalsis 145:scleroderma 124:vagus nerve 5559:Categories 5515:Peritoneal 5493:Incisional 5414:Congenital 5358:Hereditary 5335:Pancreatic 5299:Haemobilia 4972:Hemorrhoid 4950:Anal canal 4888:Infectious 4876:Functional 4711:Ulcerative 4595:Duodenitis 4534:Gastrinoma 4196:Patient UK 4150:DiseasesDB 3067:Horowitz M 2410:The Lancet 2192:2024-05-20 2170:2012-10-09 2145:2012-10-09 2073:2012-10-09 2052:2012-02-10 2027:2019-11-06 1980:"Overview" 1352:(5): e75. 1076:References 1063:Prevalence 1056:idiopathic 1009:parenteral 944:receptor ( 879:sonography 829:transducer 737:fatty acid 551:idiopathic 5503:Richter's 5460:Spigelian 5455:Obturator 5445:Umbilical 5278:Ascending 5249:Bile duct 5082:Cirrhosis 5060:Hepatitis 5043:Accessory 4913:Proctitis 4764:Megacolon 4738:Dysentery 4648:Whipple's 4600:Jejunitis 4590:Enteritis 4477:Dyspepsia 4438:Gastritis 4371:Achalasia 4304:Esophagus 4166:235675006 4161:SNOMED CT 4028:2093-0879 3799:0016-5085 3752:0149-5992 3701:0163-2116 3658:0016-5085 3413:Monograph 3354:0016-5085 3303:0002-9270 3260:0016-5085 3209:0163-2116 3156:2093-0879 3097:0017-5749 3033:0163-2116 2982:1350-1925 2930:1350-1925 2836:1350-1925 2767:0012-1797 2710:1350-1925 2659:0036-5521 2608:0002-9270 2565:0011-5029 2522:0016-5085 2430:0140-6736 2395:209258902 2246:216649955 2188:. 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